title: Use of gastrointestinal prophylaxis in NSAID patients: a cross sectional study in community pharmacies.
abstract: OBJECTIVE
  To assess the appropriateness of gastroprotective agents (GPA)\ NSAID use in patients' access medication through community pharmacy and the factors associated with any inappropriateness found.
  
  
  METHODS
  A cross-sectional study in which patients requesting NSAIDs through community pharmacy was undertaken. Information was collected through a structured questionnaire included data of patients' pharmacotherapy and gastropathy risk factors. Patients were classified as "overprotected" or "underprotected" according to the use of gastroprotective-drugs and presence/absence of gastropathy risk factors. We calculated the risk for under-or over-protection using logistic regression controlling for potential confounders.
  
  
  RESULTS
  Twenty-seven community pharmacies of Southeast of Spain participated in the study. Out of 670 NSAID users recruited in the study, 243 (36.3%) were not appropriately protected: 197(81.1%) patients were underprotected, and 46 (18.9%) patients were overprotected. Compared to patients with ulcer history, patients with cardiovascular disease or chronic morbidity (aOR 18.55; 95% CI l 3.68-93.52, P < 0.001) and aged over 60 years (aOR 23.97; 95% CI 3.93-145.9) were associated with underuse of gastroprotective-drugs. OTC-NSAID-users were more likely to be underprotected than those with medical prescription (aOR 3.47; 95% CI l 1.84-6.55).
  
  
  CONCLUSIONS
  Inappropriate GPA use is relatively frequent among NSAD users, especially in those using OTC-NSAIDs. Community pharmacists should be aware of factors contributing to NSAID-induced GI complications and assess its presence in the consumer when dispensing an OTC-NSAID.
authors.affiliation: Pharmacy and Pharmaceutics Division, Department of Engineering, University Miguel Hernandez, San Juan de Alicante, Alicante, Spain. elsa.lopez@umh.es
authors.forename: Elsa
authors.initials: E
authors.lastname: López-Pintor
authors.forename: Blanca
authors.initials: B
authors.lastname: Lumbreras
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services / Q000706:statistics & numerical data; D003257:Consumer Product Safety; D003430:Cross-Sectional Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000009:adverse effects*; D016017:Odds Ratio; D010353:Patient Education as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; D004366:Nonprescription Drugs